Bilateral diaphragm paralysis after simultaneous cardiac surgery and Nuss procedure in the infant

AbstractThe case of a 15-month-old boy with bilateral diaphragm paralysis after simultaneous cardiac surgery for tetralogy of Fallot, and Nuss procedure for pectus excavatum, is presented. Extubated one day after his first operation, the boy suffered severe respiratory distress soon after, due to bilateral diaphragmatic paralysis. Diaphragm paralysis restricted abdominal respiration, while thoracic respiration was inhibited by metallic bar after the Nuss Procedure, which combined prevented extubation for 47 days. Thoracoplasty, such as the Nuss Procedure, should not be performed simultaneously with cardiac surgery because abdominal and thoracic respiration can be restricted in infants, causing prolonged, severe, post-surgical respiratory failure

Live Migration of Virtualized Carrier Grade SIP Server

The concept of network virtualization, such as network functions virtualization, has attracted considerable attention from telecom carriers and a live migration technique is a key feature of virtualization technology. However, there are some challenges associated with applying server virtualization technology including live migration to a SIP server. Previous work has not dealt with the performance or behavior of a SIP server during live migration. Neither has it targeted a carrier grade SIP server for live migration. In this paper we present a virtualized carrier grade SIP server running on a virtual machine, which is configured with Carrier Grade Linux, HA middleware and SIP-AS application. We also assess its performance to investigate the impact of throughput degradation and suspension on a SIP layer and HA cluster configuration

Phytotoxic property of the invasive plant Tithonia diversifolia and a phytotoxic substance

Tithonia diversifolia (Hermsl.) A. Gray is a perennial invasive plant and spreads quickly in the invasive areas. The extracts of T. diversifolia were found to be toxic to several crop plant species such as rice, maize, sorghum, lettuce and cowpea, and several putative allelopathic substances were identified. However, there is limited information available for the effects of T. diversifolia on wild plants including weed plant species. We investigated the allelopathic potential of T. diversifolia extracts on weed plants, and searched for phytotoxic substances with allelopathic activity. An aqueous methanol extract of T. diversifolia leaves inhibited the growth of weed plants, Lolium multiflorum Lam., Phleum pretense L., Echinochloa crus-galli (L.) Beauv. The extract was then purified by several chromatographic runs and a phytotoxic substance with allelopathic activity was isolated and identified by spectral analysis as tagitinin C. The substance inhibited the growth of Lolium multiflorum, Phleum pratense and Echinochloa crus-galli at concentrations greater than 0.1 – 0.3 mM. The present results suggest that T. diversifolia may possess allelopathic potential on weed plants and tagitinin C may be responsible for the allelopathic effects of T. diversifolia. The allelopathic potential of T. diversifolia may contribute to its invasive characteristics

Scanning SQUID microscope system for geological samples: system integration and initial evaluation

We have developed a high-resolution scanning superconducting quantum interference device (SQUID) microscope for imaging the magnetic field of geological samples at room temperature. In this paper, we provide details about the scanning SQUID microscope system, including the magnetically shielded box (MSB), the XYZ stage, data acquisition by the system, and initial evaluation of the system. The background noise in a two-layered PC permalloy MSB is approximately 40–50 pT. The long-term drift of the system is approximately ≥1 nT, which can be reduced by drift correction for each measurement line. The stroke of the XYZ stage is 100 mm × 100 mm with an accuracy of ~10 µm, which was confirmed by laser interferometry. A SQUID chip has a pick-up area of 200 µm × 200 µm with an inner hole of 30 µm × 30 µm. The sensitivity is 722.6 nT/V. The flux-locked loop has four gains, i.e., ×1, ×10, ×100, and ×500. An analog-to-digital converter allows analog voltage input in the range of about ±7.5 V in 0.6-mV steps. The maximum dynamic range is approximately ±5400 nT, and the minimum digitizable magnetic field is ~0.9 pT. The sensor-to-sample distance is measured with a precision line current, which gives the minimum of ~200 µm. Considering the size of pick-up coil, sensor-to-sample distance, and the accuracy of XYZ stage, spacial resolution of the system is ~200 µm. We developed the software used to measure the sensor-to-sample distance with line scan data, and the software to acquire data and control the XYZ stage for scanning. We also demonstrate the registration of the magnetic image relative to the optical image by using a pair of point sources placed on the corners of a sample holder outside of a thin section placed in the middle of the sample holder. Considering the minimum noise estimate of the current system, the theoretical detection limit of a single magnetic dipole is ~1 × 10-14 Am2. The new instrument is a powerful tool that could be used in various applications in paleomagnetism such as ultrafine-scale magnetostratigraphy and single-crystal paleomagnetism

Case Report Usefulness of Infrared Thermal Imaging Camera for Screening of Postoperative Surgical Site Infection after the Nuss Procedure

Introduction and Objective. The Nuss procedure is widely used in the treatment of pectus excavatum worldwide. Postoperative pectus bar infection is one of the most serious complications associated with this procedure. Therefore, early detection of signs of implant infection is very important. However, this is difficult, and effective methods have yet to be established. Methods. We use a handheld infrared thermal imaging camera to screen patients for postoperative infection following the Nuss procedure. Here, we report a 28-year-old man with recurrent postoperative (Ravitch procedure) pectus excavatum. Results. Infrared thermography camera clearly indicated slight cellulitis in the right chest. Conclusion. Our technique may assist in preventing postoperative bar infection and removal caused by severe bar infection. Furthermore, this camera is potentially suitable for many situations in infection monitoring following subcutaneous implant surgery

Effectiveness of an Adaptive Testing Procedure for Measuring Verbal Ability

The purpose of this research is two-fold. Firstly, from a practical point of view, the development of a new computer program for an adaptive testing procedure was necessitated in order to measure the verbal ability more efficiently than the other existing procedures. Secondly, an experiment was designed in order to compare the efficiency of the adaptive testing procedure with that of the conventional testing procedure, analyze the effects of the feedback, investigate the relationship between the verbal ability and the response time, and evaluate the stability of the repeated measurements. With regard to the first purpose, a satisfactory computer program was created. This program automatically controlls the selection of test items during the process of administering the test so that the items administered to each subject should be appropriate in their difficulties. Furthermore, with regard to the second purpose, it was conculded that the results showed the superiority of the adaptive testing procedure over the conventional one in many respects

Development and reliability of a standard rating system for outcome measurement of foot and ankle disorders I: development of standard rating system

AbstractBackgroundThe aim of this study was to report the five scales comprising the rating system that the Japanese Society for Surgery of the Foot (JSSF) devised (JSSF standard rating system) and the newly offered interpretations and criteria for determinations of each assessment item.MethodsWe produced the new scales for the JSSF standard system by modifying the clinical rating systems established by the American Orthopaedic Foot and Ankle Society (AOFAS scales) and the Japanese Orthopaedic Association’s foot rating scale (JOA scale). We also provided interpretations of each assessment item and the criteria of determinations in the new standard system.ResultsWe improved the ambiguous expressions and content in the conventional standard rating systems so they would be easily understood by Japanese people. The result was five scales in total. Four were designed for use specifically for ankle-hindfoot, midfoot, hallux metatarsophalangeal- interphalangeal, and lesser metatarsophalangeal- ineterphalangeal sites; and the fifth was for the foot and ankle with rheumatoid arthritis. Furthermore, we described interpretations and criteria for determinations with regard to evaluation items in each scale.ConclusionsConventionally, the AOFAS scales or the JOA scale have been separately applied depending on the sites or disorders concerned, but it was often difficult to decide on scores during practical evaluations because of differing expressions in different languages and also because of ambiguity in the interpretation of each evaluation item and in scoring standards as well. JSSF improved these scales and added definite interpretations of evaluation items as well as criteria for the rating (to be reported here in part I). Because these steps were expected to improve the reliability of outcomes assessed by each scale, we examined the reliability in scores of the newly developed scales, which are reported in part II (in this issue)

Development and reliability of a standard rating system for outcome measurement of foot and ankle disorders II: interclinician and intraclinician reliability and validity of the newly established standard rating scales and Japanese Orthopaedic Association rating scale

AbstractBackgroundThis study evaluated the validity and inter- and intraclinician reliability of (1) the Japanese Society of Surgery of the Foot (JSSF) standard rating system for four sites [ankle- hindfoot (AH), midfoot (MF), hallux (HL), and lesser toe (LT)] and the rheumatoid arthritis (RA) foot and ankle scale and (2) the Japanese Orthopaedic Association’s foot rating scale (JOA scale).MethodsClinicians from the same institute independently evaluated participating patients from their institute by two evaluations at a 1- to 4-week interval. Statistical evaluation was as follows. (1) The intraclass correlation coefficient (ICC) was calculated from data collected from at least two examinations of each patient by at least two evaluating clinicians (Data A). (2) Total scores for the two evaluations were determined from the distribution of differences in data between the two evaluations (Data B); each item was evaluated by determining Cohen’s coefficient of agreement. (3) The relation between patient satisfaction and total score was investigated only for patients who underwent surgery (Data C). Spearman’s rank correlation coefficient was obtained.ResultsParticipants were 65 clinicians and 610 patients, including those with disorders of the AH (313), MF (47), HL (153), and LT (50) and those with RA (47). From Data A, the ICC was high for AH and HL by JSSF scales and for AH, MF, and LT by the JOA scale. From Data B, the coefficient showed high validity for both scales for AH, with almost no difference between the two scales; the validity for HL was higher with the JOA scale than with the JSSF scale. From Data C, correlations were significant between patient satisfaction and outcome for AH and HL by the JSSF scales and for AH, HL, and LT by the JOA scale.ConclusionsThe validity of both scales was high. Clinical evaluation of the therapeutic results using these scales would be highly reliable